Progress of coronary artery disease: compliance to therapy

From a sample of 1,824 patients with coronary artery disease (CAD) at the time of their interview, 827 males (M) and 251 females (F), had at least one distinct recurrence of their disease--some type of angina (A) or myocardial infarction (MI). In these patients, the age and type of CAD at the first and second manifestations (MSs) were noted, together with the patient's compliance to prescribed therapy. The first MF of CAD in Ms was A in 61% at the age of 59.4 +/- 10.15 years and MI in 39% at a significantly younger age (54.4 +/- 10.54 years, p less than 0.001). In Ms with A, the second MF was again A in 39% at the age of 61.4 +/- 10.14 years and MI in 61% at 62.1 +/- 10.2 years. In Ms with MI, the second MF was A in 85% at 56.5 +/- 10.52 years and MI in 15% at 59.2 +/- 12.0 years. No statistical difference was found between patients with good or poor compliance to therapy in connection with the time of the second MF as A or MI. A significantly lower percentage of MI after A, as the first MF, was found in patients with good compliance (55%) than in patients with poor compliance (69%, p less than 0.01). In Fs the first MF was A in 88% at 61.6 +/- 9.82 years and MI in 12% at 58.1 +/- 9.1 years (p less than 0.05). The second MF for all F patients was MI in 48% at 65.4 +/- 10.02 years, compared with A in 52% at the age of 64.5 +/- 9.78 years.

In Ms a rather quick (approximately equal to 2.5 years) progression of CAD is expected after its initial MF mainly as A (approximately equal to 61%), and in these, MI as the second MF is more common in patients with poor compliance to therapy. In Fs there is a delayed first MF mainly as A (approximately equal to 90%) and a delayed second MF as A and MI in equal proportion.